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Early childhood adversity and adolescent depression: the mediating role of continued stress

  • N. A. Hazel (a1), C. Hammen (a1), P. A. Brennan (a2) and J. Najman (a3)

While various conceptualizations of the link between childhood adversity and later depression have been offered, most have not accounted for the possibility that early adversity predicts continuing stress proximal to depression onset. Thus, the present study tested the possible mediating role of recent stress in the association between early adversity and depression in late adolescence.


Study questions were examined in a longitudinal community sample of 705 youth who were contemporaneously assessed for early adversity exposure prior to age 5 years, chronic and episodic stress at age 15 years, and major depression prior to age 15 years and between 15 and 20 years.


Total youth stress burden at age 15 years mediated the effect of early adversity on depression between ages 15 and 20 years, and none of the observed relationships were moderated by onset of depression prior to age 15 years.


These findings suggest that continued stress exposure proximal to depression onset largely accounts for the association between early adversity and depression in late adolescence. Intervention should thus focus on disrupting the continuity of stressful conditions across childhood and adolescence. Future studies of the neurobiological and psychosocial mechanisms of the link between early experiences and depression should explore whether the effects of early experiences are independent of continuing adversity proximal to depressive onset.

Corresponding author
*Address for correspondence: C. Hammen, Ph.D., Department of Psychology, University of California, Los Angeles, CA 90095, USA. (Email:
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Adrian C, Hammen C (1993). Stress exposure and stress generation in children of depressed mothers. Journal of Consulting and Clinical Psychology 61, 354359.
Beck AT, Ward CH, Mendelsohn M, Mock J, Erbaugh J (1961). An inventory for measuring depression. Archives of General Psychiatry 4, 561571.
Bedford A, Foulds G (1977). Validation of the Delusions-Symptoms-States Inventory. British Journal of Medical Psychology 50, 163171.
Brown GW, Harris T (1978). Social Origins of Depression. Free Press: London.
Brown GW, Harris TO (1993). Aetiology of anxiety and depressive disorders in an inner-city population: I. Early adversity. Psychological Medicine 23, 143154.
Cole DA, Nolen-Hoeksema S, Girgus J, Paul G (2006). Stress exposure and stress generation in child and adolescent depression: a latent trait-state-error approach to longitudinal analyses. Journal of Abnormal Psychology 115, 4051.
First MB, Spitzer RL, Gibbon M, Williams JBW (1995). Structured Clinical Interview for DSM-IV Axis I Disorders. American Psychiatric Press: Washington, DC.
Garber J (2006). Depression in children and adolescents: linking risk research and prevention. American Journal of Preventative Medicine 31 (Suppl.), S104S125.
Goodman SH (2002). Depression and early adverse experiences. In Handbook of Depression (ed. Gotlib I. H. and Hammen C. L.), pp. 245267. Guilford: New York.
Hammen C (1991). Generation of stress in the course of unipolar depression. Journal of Abnormal Psychology 100, 555561.
Hammen C (2005). Stress and depression. Annual Review of Clinical Psychology 1, 293319.
Hammen C (2006). Stress generation in depression: reflections on origin, research, and future directions. Journal of Clinical Psychology 62, 10651082.
Hammen C, Adrian C, Gordon D, Burge D, Jaenicke C, Hiroto D (1987). Children of depressed mothers: maternal strain and symptom predictors of dysfunction. Journal of Abnormal Psychology 96, 190198.
Hammen C, Brennan PA (2001). Depressed adolescents of depressed and nondepressed mothers: tests of an interpersonal impairment hypothesis. Journal of Consulting and Clinical Psychology 69, 284294.
Hammen C, Henry R, Daley SE (2000). Depression and sensitization to stressors among young women as a function of childhood adversity. Journal of Consulting and Clinical Psychology 68, 782787.
Hankin BL (2005). Childhood maltreatment and psychopathology: prospective tests of attachment, cognitive vulnerability, and stress as mediating processes. Cognitive Therapy and Research 29, 645671.
Harkness KL, Bruce AE, Lumley MN (2006). The role of childhood abuse and neglect in the sensitization to stressful life events in adolescent depression. Journal of Abnormal Psychology 115, 730741.
Heim C, Newport DJ, Heit S, Graham YP, Wilcox M, Bonsall R, Miller AH, Nemeroff CB (2000). Pituitary-adrenal and autonomic responses to stress in women after sexual and physical abuse in childhood. Journal of the American Medical Association 284, 592597.
Heim C, Newport DJ, Wagner D, Wilcox MM, Miller AH, Nemeroff CB (2002). The role of early adverse experience and adulthood stress in the prediction of neuroendocrine stress reactivity in women: a multiple regression analysis. Depression and Anxiety 15, 117125.
Jaffee SR, Price TS (2007). Gene-environment correlations: a review of the evidence and implications for the prevention of mental illness. Molecular Psychiatry 12, 432442.
Kendler KS, Karkowski LM, Prescott CA (1999). Causal relationship between stressful life events and the onset of major depression. American Journal of Psychiatry 156, 837848.
Kendler KS, Kuhn JW, Prescott CA (2004). Childhood sexual abuse, stressful life events, and risk for major depression in women. Psychological Medicine 34, 14751482.
Kessler RC, Avenevoli S, Merikangas KR (2001). Mood disorders in children and adolescents: an epidemiological perspective. Biological Psychiatry 49, 10021014.
Kessler RC, Davis CG, Kendler KS (1997). Childhood adversity and adult psychiatric disorder in the US National Comorbidity Survey. Psychological Medicine 27, 11011119.
Kessler RC, Magee WJ (1993). Childhood adversities and adult depression: basic patterns of association in a US national survey. Psychological Medicine 23, 679690.
Kessler RC, Walters EE (1998). Epidemiology of DSM-III-R major depression and minor depression among adolescents and young adults in the National Comorbidity Survey. Depression and Anxiety 7, 314.
Lewinsohn PM, Rohde P, Seeley JR (1998). Major depressive disorder in older adolescents: prevalence, risk factors, and clinical implications. Clinical Psychology Review 18, 765794.
MacKinnon DP, Dwyer JH (1993). Estimating mediated effects in prevention studies. Evaluation Review 17, 144158.
MacKinnon DP, Fritz MS, Williams J, Lockwood CM (2007). Distribution of the product confidence limits for the indirect effect: program PRODCLIN. Behavioral Research Methods 39, 384389.
MacKinnon DP, Lockwood CM, Hoffman JM, West SG, Sheets V (2002). A comparison of methods to test mediation and other intervening variable effects. Psychological Methods 7, 83104.
Mazure CM (1998). Life stressors as risk factors in depression. Clinical Psychology: Science and Practice 5, 291313.
Monroe SM, Harkness KL (2005). Life stress, the ‘kindling’ hypothesis, and the recurrence of depression: considerations from a life stress perspective. Psychological Review 112, 417445.
Orvaschel H (1995). Schedule for Affective Disorder and Schizophrenia for School-age Children – Epidemiologic Version – 5. Nova Southeastern University, Center for Psychological Studies: Fort Lauderdale, FL.
Pearlin LI (1989). The sociological study of stress. Journal of Health and Social Behavior 30, 241256.
Rao U, Hammen C, Daley SE (1999). Continuity of depression during the transition to adulthood: a 5-year longitudinal study of young women. Journal of the American Academy of Child and Adolescent Psychiatry 38, 908915.
Rudolph K, Hammen C, Daley S (2006). Adolescent mood disorders. In Behavioral and Emotional Disorders in Adolescence: Nature, Assessment, and Treatment (ed. Wolfe D. A. and Mash E. J.), pp. 300342. Guilford: New York.
Rueter MA, Scaramella L, Wallace LE, Conger RD (1999). First onset of depressive or anxiety disorders predicted by the longitudinal course of internalizing symptoms and parent-adolescent disagreements. Archives of General Psychiatry 56, 726732.
Spanier GB (1976). Measuring dyadic adjustment: new scales for assessing the quality of marriage and similar dyads. Journal of Marriage and the Family 38, 1528.
Taylor SE, Way BM, Welch WT, Hilmert CJ, Lehman BJ, Eisenberger NI (2006). Early family environment, current adversity, the serotonin transporter polymorphism, and depressive symptomatology. Biological Psychiatry 60, 671676.
Turner HA, Butler MJ (2003). Direct and indirect effects of childhood adversity on depressive symptoms in young adults. Journal of Youth and Adolescence 32, 89103.
Turner HA, Turner RJ (2005). Understanding variations in exposure to social stress. Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine 9, 209240.
Turner RJ, Lloyd DA (1995). Lifetime traumas and mental health: the significance of cumulative adversity. Journal of Health and Social Behavior 36, 360376.
Turner RJ, Lloyd DA (2004). Stress burden and the lifetime incidence of psychiatric disorder in young adults: racial and ethnic contrasts. Archives of General Psychiatry 61, 481488.
Turner RJ, Wheaton B, Lloyd DA (1995). The epidemiology of social stress. American Sociological Review 60, 104125.
Uhrlass DJ, Gibb BE (2007). Childhood emotional maltreatment and the stress generation model of depression. Social and Clinical Psychology 26, 119130.
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